Patterns of epidermal growth factor receptor, basic fibroblast growth factor and transforming growth factor-beta3 expression in skin with chronic venous insufficiency.

Growth factors which act as signalling peptides through specific cell surface receptors are involved in functions such as cell proliferation, migration, and differentiation. Here, we report on alterations of the epidermal growth factor receptor (EGFR), basic fibroblast growth factor (bFGF) and transforming growth factor beta3 (TGF-beta3) expression patterns in the skin at various stages of chronic venous insufficiency (CVI). Thirty punch biopsies were taken from patients with CVI and growth factors or the growth factor receptor were detected by indirect immunofluorescence and immunoperoxidase techniques. EGFR, bFGF, and TGF-beta3 expression is strongly increased in the stroma of venous eczema and in leg ulcer skin, and to a lesser extent in the dermis of patients with lipodermatosclerosis. Venous eczema and lipodermatosclerosis epidermis show an elevated EGFR and bFGF synthesis throughout all strata. In the different CVI stages, telangiectases and reticular veins and pigmentation EGFR and bFGF staining are limited to the basal layer. We conclude that the alterations in the expression of EGFR, bFGF and TGF-beta3 precede changes in the affected skin within progressing stages of CVI. The exact mechanisms of growth factor involvement in the pathogenesis of venous ulceration remain to be resolved.